AI Article Synopsis
- Acute promyelocytic leukemia (APL) is a rare and serious condition that can occur during pregnancy, complicating cases with severe coagulopathy.
- A case study of a 23-year-old pregnant woman showed APL manifesting alongside severe pre-eclampsia, with indicators like intrauterine fetal demise and thrombocytopenia, which was confirmed through blood tests.
- The successful treatment of APL led to the patient's complete molecular remission, highlighting the need for teamwork among healthcare specialists in managing pregnancy complications linked to blood disorders.
Article Abstract
Acute promyelocytic leukemia (APL) manifesting during pregnancy is a very rare but highly challenging gestational complication in part due to its associated profound coagulopathy. We present the case of a 23-year-old Gravida 3 Para 2002 woman admitted to our hospital at 26 weeks of gestation for severe pre-eclampsia with documentation of intrauterine fetal demise (IUFD), thrombocytopenia, and placental abruption. A peripheral blood smear revealed promyelocytes with azure granules, highly concerning for APL. Additional peripheral blood studies confirmed APL. Placental examination also revealed circulating blasts in decidual vessels and scattered blast entrapment in diffuse perivillous fibrinoid deposits, but none in the chorionic villi. Treatment for APL was initiated immediately and she is in complete molecular remission. Our case underscores the importance of close collaboration among obstetric, hematology, and pathology teams in the care of patients with pre-eclampsia, thrombocytopenia, and postpartum coagulopathy. We also describe five additional cases of gestations complicated by hematologic malignancies identified upon a 10-year institutional retrospective review.
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| http://dx.doi.org/10.1016/j.prp.2019.152672 | DOI Listing |
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